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Anticancer Medications and Sodium Dysmetabolism
- Source :
- Eur Endocrinol
- Publication Year :
- 2020
- Publisher :
- Touch Medical Media, 2020.
-
Abstract
- Therapeutic advances have revolutionised cancer treatment over the last two decades, but despite improved survival and outcomes, adverse effects to anticancer therapy such as dyselectrolytaemias do occur and need to be managed appropriately. This review explores essential aspects of sodium homeostasis in cancer with a focus on alterations arising from anticancer medications. Sodium and water balance are tightly regulated by close interplay of stimuli arising from hypothalamic osmoreceptors, arterial and atrial baroreceptors and the renal juxtaglomerular apparatus. This delicate balance can be disrupted by cancer itself, as well as the medications used to treat it. Some of the conventional chemotherapeutics, such as alkylating agents and platinum-based drugs, can cause hyponatraemia and, on rare occasions, hypernatraemia. Other conventional agents such as vinca alkaloids, as well as newer targeted cancer therapies including small molecule inhibitors and monoclonal antibodies, can cause hyponatraemia, usually as a result of inappropriate antidiuretic hormone secretion. Hyponatraemia can also sometimes occur secondarily to drug-induced hypocortisolism or salt-wasting syndromes. Another atypical but distinct mechanism for hyponatraemia is via pituitary dysfunction induced by immune checkpoint inhibitors. Hypernatraemia is uncommon and occasionally ensues as a result of drug-induced nephrogenic diabetes insipidus. Identification of the aetiology and appropriate management of these conditions, in addition to averting treatment-related problems, can be lifesaving in critical situations.
- Subjects :
- 0303 health sciences
Endocrine and Autonomic Systems
business.industry
Mechanism (biology)
Endocrinology, Diabetes and Metabolism
Cancer
Juxtaglomerular apparatus
Nephrogenic diabetes insipidus
medicine.disease
Bioinformatics
03 medical and health sciences
0302 clinical medicine
Endocrinology
medicine.anatomical_structure
030220 oncology & carcinogenesis
medicine
Endocrine Oncology
business
Adverse effect
Homeostasis
030304 developmental biology
Antidiuretic
Hormone
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Eur Endocrinol
- Accession number :
- edsair.doi.dedup.....7342b6aa6a8157da0dfdff15def8e86e